Neuroblastoma in adolescents.

Area of Science:

• Pediatric Oncology
• Cancer Research
• Adolescent Medicine

Background:

• Neuroblastoma diagnosis is uncommon in adolescent patients (over 10 years old), representing less than 5% of cases.
• Previous research suggested better survival in adolescents treated with less intensive chemotherapy, potentially linked to a lack of myc-N amplification.
• This prompted an investigation into a cohort of adolescent neuroblastoma patients within more recent clinical trials.

Purpose of the Study:

• To investigate the clinical presentation, treatment, and outcomes of neuroblastoma in adolescent patients.
• To compare the outcomes of adolescent neuroblastoma patients with a control group of younger children.

Main Methods:

• Analysis of 28 adolescent patients (age >10 years) diagnosed with neuroblastoma between 1987 and 1999, enrolled in French Society of Pediatric Oncology studies.
• Comparison of this adolescent subpopulation with a control group of children.

Main Results:

• Patients with Stage I-II disease showed no recurrence or mortality.
• Adolescents with Stage III disease had high progression (28% progression-free survival [PFS]) but also high survival (86% overall survival [OS]).
• Adolescents with metastatic neuroblastoma had poor outcomes (18% PFS, 27% OS). Advanced neuroblastoma carried a poorer prognosis in adolescents than in children, despite intensive therapy, with Stage III disease showing a more indolent course. No significant differences were observed in clinical presentation, treatment schedules, chemotherapy doses, or tolerance between adolescents and children. Lower incidence of elevated urinary catecholamine metabolite secretion was noted in adolescents.

Conclusions:

• Adolescent patients diagnosed with advanced neuroblastoma generally experience less favorable outcomes compared to children.
• However, adolescents with Stage III neuroblastoma may exhibit longer survival rates.